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Pulmonary Embolism Support Group

Blog Intro: Notes from a Doctor's Practice

By Dr. Orrange March 30, 2008 9:13pm 29 Comments

For almost three years you have seen my posts in many communities and I have been able to jump in to discussions when possible. Well, because Dailystrength has grown we are trying a new format to reach as many of you as we can: "Notes from a Doctor's Practice" will be my new blog.

I plan on covering important news in medicine, new study results, …

Pulmonary Embolism Information

By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death. Treatment is with anticoagulant medication, such as warfarin. Other rarer forms of pulmonary embolism occur when material other than a blood clot is responsible. Such materials can include fat or bone (usually in association with significant trauma), air (often when diving), and amniotic fluid (affecting mothers during child-birth).

Signs of PE are sudden-onset dyspnea (shortness of breath, 73%), tachypnea (rapid breathing, 70%), chest pain of "pleuritic" nature (worsened by breathing, 66%), cough (37%), hemoptysis (coughing up blood, 13%), and in severe cases, cyanosis, tachycardia (rapid heart rate), hypotension, shock, loss of consciousness, and death. Although most cases have no clinical evidence of deep venous thrombosis (DVT) in the legs, findings that indicate DVT may aid in the diagnosis.

Acutely, supportive treatments, such as oxygen or analgesia, are often required.

Massive PE causing hemodynamic instability (marked decreased oxygen saturation, tachycardia and/or hypotension) is an indication for thrombolysis, the enzymatic destruction of the clot with medication. Some advocate its use also if right ventricular dysfunction can be demonstrated on echocardiography.

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